MATILDE FONSECA (NPI# 1639721517) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639721517 |
| Entity Type | Individual |
| Full Name | MATILDE FONSECA |
| Credential | LMHC |
| Practice Address |
205 W Busch Blvd Tampa FL 33612-7900 |
| Mailing Address |
12171 Sw 268th St Homestead FL 33032-8001 |
| Practice Telephone | 1391515888 |
| Practice Fax Number | 8139151589 |
| Mailing Telephone | 3052780200 |
| Enumeration Date | 2019-07-11 |
| Last Update Date | 2020-10-15 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
MH17049 | FL | Behavioral Health & Social Service Providers |
| Street Address |
205 W BUSCH BLVD |
| City | TAMPA |
| State | FL |
| Zip Code | 33612-7900 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740275916 | Jose A. Aleman-gomez | Internal Medicine | 205 W Busch Blvd, Tampa, FL 33612 | 2005-09-14 |
| 1396353249 | Orelfy Sanchez Naranjo | Nurse Practitioner | 205 W Busch Blvd, Tampa, FL 33612-7900 | 2020-07-16 |
| 1780243402 | Diana Maria Tigoudar | Massage Therapist | 205 W Busch Blvd, Tampa, FL 33612-7900 | 2019-06-06 |
| 1215407671 | Mayelin Gonzalez | Registered Nurse | 205 W Busch Blvd, Tampa, FL 33612-7900 | 2018-11-28 |
| 1306358502 | Arnaldo Acevedo | Nurse Practitioner | 205 W Busch Blvd, Tampa, FL 33612-7900 | 2017-10-27 |
| 1770010506 | Sonia Benitez Cedeno | Nurse Practitioner | 205 W Busch Blvd, Tampa, FL 33612 | 2017-05-11 |
| 1548706104 | American Care of Tampa, Inc. | General Practice | 205 W Busch Blvd, Tampa, FL 33612-7900 | 2017-01-06 |
| 1710297635 | Chiro-injury and Wellness, LLC | Chiropractor | 205 W Busch Blvd, Tampa, FL 33612-7900 | 2010-10-13 |
| 1013014281 | Gerardo Gomez Cordoba | General Practice | 205 W Busch Blvd, Tampa, FL 33612-7900 | 2006-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689286767 | Daniel Jimenez | Physical Therapist | 13000 Bruce B Downs Blvd, Tampa, Fl, Tampa, FL 33612 | 2020-08-19 |
| 1700426830 | Taz Stacy | Behavior Technician | 2701 University Square Drive, Tampa, FL 33612 | 2020-01-07 |
| 1841853215 | Eric Austen Keeler | Student in an Organized Health Care Education/Training Program | 12901 Bruce B Downs Blvd, Mdc5, Tampa, FL 33612 | 2019-04-20 |
| 1346700242 | Caitlyn Victoria Cartwright | Student in an Organized Health Care Education/Training Program | 12901 Bruce B. Downs Blvd., Mdc5, Tampa, FL 33612 | 2019-03-25 |
| 1720552953 | Marijo Bilitski | Student in an Organized Health Care Education/Training Program | 12901 Bruce B Downs Blvd # Blvd5, Tampa, FL 33612 | 2019-01-22 |
| 1790259190 | Belkis Aleman | Nurse Practitioner | 205 E Busch Blvd, Tampa, FL 33612 | 2019-01-18 |
| 1811469133 | Stephanie Stegner | Physician Assistant | 12901 Bruce B Downs Blvd Mdc 5, Tampa, FL 33612 | 2018-12-27 |
| 1053889857 | Alysia Heather Siegel | Psychologist | 1300 Bruce B. Downs Boulevard, 116b, Tampa, FL 33612 | 2018-11-09 |
| 1295202489 | Daisy Baby Pulinilkumkalayil | Nurse Practitioner | 1426 W. Bush Blvd. Suite #105, Suite #105, Tampa, FL 33612 | 2018-10-26 |
| 1649745258 | Rachel Rene Shelton | Specialist/Technologist | Orthopedics and Sports Medicine, 13330 Usf Laurel Drive, Tampa, FL 33612 | 2018-10-10 |
| Find all providers in zip 33612 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316546146 | Rebecca M Slack | Counselor | 4422 E Columbus Dr Fl 33605, Tampa, FL 33605-3233 | 2020-10-22 |
| 1003415852 | Betsy Rose Rodriguez | Counselor | 1101 E Cumberland Ave # 201h-132, Tampa, FL 33602-4231 | 2020-10-22 |
| 1124626155 | Laverne Brown | Counselor | 10964 Brightside Dr, Tampa, FL 33624-7007 | 2020-10-12 |
| 1639786064 | Brittany Richardson Smiley | Counselor | 1610 E Osborne Ave, Tampa, FL 33610-6045 | 2020-09-29 |
| 1356957492 | Latoya K Claxton | Counselor | 17106 Carrington Park Dr Apt 601, Tampa, FL 33647-2627 | 2020-09-22 |
| 1679188718 | Jessica Marie Graham | Counselor | 3038 W Bearss Ave, Tampa, FL 33618-1811 | 2020-09-15 |
| 1952915795 | Kathy Thompson | Counselor | 4115 W Spruce St Ste 205, Tampa, FL 33607-2485 | 2020-08-31 |
| 1467066233 | Samantha Tubbs-crews, Lmhc | Counselor | 1211 N West Shore Blvd Ste 100, Tampa, FL 33607-4601 | 2020-08-31 |
| 1699388744 | R.e.s.e.t. Counseling Services LLC | Counselor | 1806 E Hanna Ave, Tampa, FL 33610-3543 | 2020-08-28 |
| 1700401056 | Jamie Tyus | Counselor | 3825 Henderson Blvd Ste 404, Tampa, FL 33629-5012 | 2020-06-12 |
| Find all providers in TAMPA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.